This document summarizes vitrification as an improved method for freezing embryos compared to slow freezing. It discusses the benefits of vitrification such as higher survival rates and pregnancy outcomes. It also outlines protocols for natural cycle and endometrial preparation frozen embryo transfers. Strategies are provided for improving endometrial lining in patients with poor responses. The Kato protocol of electively freezing all embryos and performing only frozen transfers is presented as the new gold standard.
This document discusses luteal phase support in IVF. It explains that ovarian stimulation and follicular aspiration in IVF can compromise the corpus luteum, leading to luteal phase deficiency. Various medications are used for luteal phase support, including progesterone, HCG, estrogen, LH, GnRH agonists, aspirin, heparin, prednisolone, and sildenafil. Progesterone supplementation is considered mandatory for luteal phase support, while HCG is not recommended due to risk of OHSS. Estrogen may be used with progesterone. The role of other supplements like GnRH agonists requires more research. Luteal phase support is typically continued until a heartbeat is detected, around 6-
The document discusses peripartum hysterectomy, including its definition, history, incidence and trends, risk factors, types, indications, complications, and techniques. A key point is that a sequence of conservative measures should be attempted before hysterectomy to control uterine hemorrhage, as indecisiveness can lead to fatal excessive bleeding. The "Triple-P procedure" is also summarized as a three-step conservative approach involving obstetric, anesthesia and interventional radiology teams to prevent hemorrhage and need for hysterectomy in high-risk cases.
Hysteroscopic procedures are getting refined and with the advent of miniature scopes , doing these procedures in he office is getting better and more comfortable.
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
This document summarizes research comparing outcomes of fresh embryo transfers versus frozen embryo transfers (FET). Key points include:
- FET outcomes were found to equal or exceed fresh outcomes, suggesting endometrial asynchrony with fresh cycles due to ovarian stimulation effects.
- Slower developing day 6 blastocysts showed lower implantation rates than day 5 blastocysts with fresh but not FET transfers, again indicating endometrial asynchrony issues with fresh cycles.
- Studies directly comparing matched fresh and FET cycles found significantly higher pregnancy and implantation rates with FET, demonstrating cryopreservation can overcome negative endometrial effects of ovarian stimulation.
This document summarizes vitrification as an improved method for freezing embryos compared to slow freezing. It discusses the benefits of vitrification such as higher survival rates and pregnancy outcomes. It also outlines protocols for natural cycle and endometrial preparation frozen embryo transfers. Strategies are provided for improving endometrial lining in patients with poor responses. The Kato protocol of electively freezing all embryos and performing only frozen transfers is presented as the new gold standard.
This document discusses luteal phase support in IVF. It explains that ovarian stimulation and follicular aspiration in IVF can compromise the corpus luteum, leading to luteal phase deficiency. Various medications are used for luteal phase support, including progesterone, HCG, estrogen, LH, GnRH agonists, aspirin, heparin, prednisolone, and sildenafil. Progesterone supplementation is considered mandatory for luteal phase support, while HCG is not recommended due to risk of OHSS. Estrogen may be used with progesterone. The role of other supplements like GnRH agonists requires more research. Luteal phase support is typically continued until a heartbeat is detected, around 6-
The document discusses peripartum hysterectomy, including its definition, history, incidence and trends, risk factors, types, indications, complications, and techniques. A key point is that a sequence of conservative measures should be attempted before hysterectomy to control uterine hemorrhage, as indecisiveness can lead to fatal excessive bleeding. The "Triple-P procedure" is also summarized as a three-step conservative approach involving obstetric, anesthesia and interventional radiology teams to prevent hemorrhage and need for hysterectomy in high-risk cases.
Hysteroscopic procedures are getting refined and with the advent of miniature scopes , doing these procedures in he office is getting better and more comfortable.
Ovarian reserve refers to the reproductive potential left within a woman's two ovaries based on number and quality of eggs. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs
This document summarizes research comparing outcomes of fresh embryo transfers versus frozen embryo transfers (FET). Key points include:
- FET outcomes were found to equal or exceed fresh outcomes, suggesting endometrial asynchrony with fresh cycles due to ovarian stimulation effects.
- Slower developing day 6 blastocysts showed lower implantation rates than day 5 blastocysts with fresh but not FET transfers, again indicating endometrial asynchrony issues with fresh cycles.
- Studies directly comparing matched fresh and FET cycles found significantly higher pregnancy and implantation rates with FET, demonstrating cryopreservation can overcome negative endometrial effects of ovarian stimulation.
This document discusses various ovulation induction protocols including:
- Clomiphene citrate is commonly used as a first line treatment but some women are clomiphene resistant.
- Gonadotropins like hMG can cause multifollicular development and increase risks of complications like OHSS.
- A novel protocol uses a combination of hMG for several days followed by clomiphene to promote monofollicular development while reducing risks of complications. Initial studies found this protocol increased follicle recruitment over hMG alone without increasing LH levels or risks.
Fertility Preservation for Gynecologic Cancer PatientsJibran Mohsin
This document discusses fertility preservation options for young women diagnosed with gynecologic cancers. It covers cervical, endometrial, and ovarian cancers. For early-stage cervical cancer, conization or radical trachelectomy can allow fertility preservation. For early-stage endometrial cancer, hormonal treatment with progesterone may induce remission and allow attempted pregnancy. For early-stage ovarian cancers including borderline tumors and germ cell tumors, fertility-sparing surgery such as unilateral salpingo-oophorectomy may be an option. Patient selection is crucial to balance oncologic and fertility outcomes.
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses cervical cerclage, a surgical procedure used to treat and prevent preterm birth. It provides guidelines on when cervical cerclage is indicated based on history of prior preterm births or short cervical length on ultrasound. Major professional organizations like ACOG, RCOG, and SOGC recommend offering cervical cerclage to women with a history of late second trimester losses or prior preterm births before 34 weeks who currently have a short cervix. Cerclage placement can reduce the risks of preterm birth, low birthweight, and perinatal mortality.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
This document discusses the investigation and management of postmenopausal uterine bleeding. It describes the most common causes as atrophic vaginitis (60-80%), estrogen treatments (15-25%), and polyps (2-12%). Transvaginal ultrasound is recommended to measure endometrial thickness, with <3mm making cancer unlikely. Additional tests may include saline infusion sonography, hysteroscopy, and endometrial biopsy. Treatment depends on the cause but includes topical estrogen for atrophic vaginitis, polypectomy, and hysterectomy with bilateral oophorectomy for cancer. Recurrent bleeding warrants hysteroscopy and dilation and curettage.
This document outlines 10 secrets to success for intrauterine insemination (IUI). It discusses factors such as choosing the right patients based on their infertility diagnosis and prognosis, understanding the patient's ovarian and endometrial response based on age and biomarkers, using an individualized ovarian stimulation protocol, modifying treatment based on endometrial thickness, proper follicle monitoring and HCG trigger timing, optimizing IUI timing and semen preparation, ensuring proper IUI technique, providing luteal phase support with vaginal progesterone, knowing when to stop IUI treatment, and maintaining a cohesive team with thorough documentation and analysis of results. The overall message is that success in IUI lies in attention to many details of patient selection, treatment planning
This document discusses the importance of evidence-based fertility practice. It provides examples of how evidence-based medicine involves asking answerable clinical questions, acquiring the best evidence to answer those questions, and appraising the validity and applicability of the evidence. The document gives examples of evaluating studies on using metformin for PCOS and triggering ovulation with HCG. It emphasizes integrating the best available evidence with clinical expertise and patient values and preferences.
Uterine fibroids are common non-cancerous tumors that can affect fertility. Submucosal fibroids that distort the uterine cavity have been shown to decrease pregnancy rates, while evidence for intramural fibroids is less clear. Treatment options include medical therapy, uterine artery embolization, hysteroscopic or laparoscopic myomectomy. Myomectomy can improve fertility outcomes, especially for submucosal fibroids, but carries risks of adhesion formation and possible increased risk of uterine rupture in future pregnancies. More research is still needed to fully understand the relationship between fibroid location, size and infertility.
IUI remains an effective treatment option for certain fertility issues like unexplained infertility, mild male factor infertility, and infertility due to cervical factors. Stimulated IUI cycles have higher success rates than natural cycles. Optimal timing of IUI is 36-40 hours after hCG administration. IUI can be considered for poor responders to IVF as an alternative to cancellation. Success rates of IUI decline significantly after age 40. IUI may not be as effective as IVF for cases involving distal unilateral tubal blockage or hydrosalpinx. Strict protocols should be followed when performing IUI for HIV discordant couples.
The document provides guidelines for making IUI cost effective. It recommends proper patient selection, necessary investigations like checking tubal patency and ovulation, and optimum monitoring. It suggests using low doses of gonadotropins for stimulation and a single insemination per cycle. The number of IUI cycles should be decided based on factors like age, with a maximum of 6 cycles for patients under 35. Referral to IVF should be done at the appropriate time. Close monitoring involves tracking follicle growth and an hCG trigger when the follicle reaches 18mm. The guidelines aim to individualize treatment and keep the process as simple as possible to reduce costs.
Fertility preservation in Cancer patientsArunSharma10
The need for fertility preservation
Chemotherapeutic drugs according to gonadotoxicity level
Fertility preservation: subject of continuous review by experts
Non-oncological conditions requiring fertility preservation
Delayed childbearing
AVAILABLE PROCEDURES FOR FP
Embryo and oocyte cryopreservation
Luteal Phase - Clinical Point of View - By Dr Dhorepatil BharatiBharati Dhorepatil
Maintenance of pregnancy
Corpus luteum Progesterone
After ovulation ~ during the early first trimester ~ until placental function established
Removal of the corpus luteum spontaneous pregnancy loss
Ovarian progesterone production implantation & early pregnancy
This document discusses different methods for endometrial preparation in frozen embryo transfer cycles. It summarizes that:
1) Natural cycles can be used for younger patients but have limitations like irregular cycles and difficulty timing ovulation.
2) Hormonally controlled cycles using estrogen and progesterone with or without GnRH agonists are effective options. Exogenous hormone administration without GnRH agonists is now commonly used as it is simple and effective.
3) Factors like embryo quality and endometrial thickness predict success, but preparation method, hormone type/administration, and cryostorage length do not affect outcomes. The best predictors are good quality embryos and a tri-laminar endometrial pattern.
Robotic surgery has advantages over conventional and laparoscopic surgery for gynecological procedures. The da Vinci surgical system allows for precision in complex surgeries through its three-dimensional view and wristed instruments. Robotic surgery results in less blood loss, quicker recovery times, and fewer complications compared to open surgeries. While further research is still needed, robotic surgery has become a common method for hysterectomies and myomectomies to treat conditions like fibroids and cancer. The case study describes a large fibroid removed robotically with minimal blood loss and fast recovery for the patient.
Fertility preservation options are important for cancer patients of reproductive age undergoing treatment. For women, established options include embryo freezing for married patients and oocyte freezing for single patients, both of which require delaying cancer treatment. Ovarian tissue freezing can be done at any age or relationship status and does not delay treatment, but reimplantation success is currently low. For pre-pubertal patients, ovarian tissue or testicular tissue freezing are the only available options. Future methods may allow in vitro gamete maturation or stem cell derived gametes. Multidisciplinary care and individualized counseling are key to help patients preserve their fertility whenever possible before cancer treatment.
This document lists the professional qualifications and positions held by Dr. Laxmi Shrikhande, including Chairperson for various medical committees, publications, awards received, and presentations given. It then provides an overview of her upcoming presentation on Perimenopausal Bleeding, covering definitions, classifications, evaluation, treatment options for structural and non-structural causes, and specific treatment approaches like hormonal therapy, NSAIDs, and levonorgestrel intrauterine devices.
1. Thyroid disorders are common in pregnancy, affecting 1-2% of pregnant women. Optimal management is important for pregnancy outcomes.
2. Hypothyroidism and hyperthyroidism can cause complications for both mother and fetus if not treated properly. Levothyroxine is the treatment of choice for hypothyroidism. Antithyroid drugs are used to treat hyperthyroidism.
3. Factors like hCG and estrogen increase thyroid function in pregnancy, requiring adjustments to diagnosis and treatment of thyroid disorders compared to non-pregnant individuals. Monitoring of thyroid levels is important during and after pregnancy.
This document discusses ovarian cortical strips transplantation as a method for fertility preservation. It describes how ovarian cortical tissue can be removed, prepared into thin strips, and transplanted to various locations in the body. Locations mentioned include remaining ovaries, pelvic walls, abdominal muscles, and under the skin of the forearm or abdomen. The goals are to maintain hormone levels and potentially allow for future natural conception. Success is determined by restoration of hormone levels and follicular development visible on ultrasound over subsequent months.
Antenatal care involves regular checkups during pregnancy to monitor the health of the expectant mother and baby. The goals are to reduce mortality and morbidity, identify issues, and educate mothers. Checkups are usually every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly until delivery. Appointments include health history, physical exam, lab tests, ultrasound, and health advice covering hygiene, nutrition, exercise, sleep, and danger signs. The overall aim is a healthy pregnancy and delivery.
The document discusses postpartum care and assessment. It describes how the body reverts to its pre-pregnancy state after childbirth and defines the postpartum period. It outlines components of a postpartum exam including assessing the breasts, uterus, bladder, bowels, lochia, episiotomy, Homan's sign, and emotional status. It provides guidance on common concerns like breastfeeding, bleeding, bowel movements, and perineal care. The document aims to inform nurses on properly examining and caring for postpartum patients.
This document discusses various ovulation induction protocols including:
- Clomiphene citrate is commonly used as a first line treatment but some women are clomiphene resistant.
- Gonadotropins like hMG can cause multifollicular development and increase risks of complications like OHSS.
- A novel protocol uses a combination of hMG for several days followed by clomiphene to promote monofollicular development while reducing risks of complications. Initial studies found this protocol increased follicle recruitment over hMG alone without increasing LH levels or risks.
Fertility Preservation for Gynecologic Cancer PatientsJibran Mohsin
This document discusses fertility preservation options for young women diagnosed with gynecologic cancers. It covers cervical, endometrial, and ovarian cancers. For early-stage cervical cancer, conization or radical trachelectomy can allow fertility preservation. For early-stage endometrial cancer, hormonal treatment with progesterone may induce remission and allow attempted pregnancy. For early-stage ovarian cancers including borderline tumors and germ cell tumors, fertility-sparing surgery such as unilateral salpingo-oophorectomy may be an option. Patient selection is crucial to balance oncologic and fertility outcomes.
DEBATE - SHORT CERVIX - OS TIGHTNING BY DR SHASHWAT JANIDR SHASHWAT JANI
This document discusses cervical cerclage, a surgical procedure used to treat and prevent preterm birth. It provides guidelines on when cervical cerclage is indicated based on history of prior preterm births or short cervical length on ultrasound. Major professional organizations like ACOG, RCOG, and SOGC recommend offering cervical cerclage to women with a history of late second trimester losses or prior preterm births before 34 weeks who currently have a short cervix. Cerclage placement can reduce the risks of preterm birth, low birthweight, and perinatal mortality.
Uterus Transplantation Utx (obstetric and gynecology) D.A.B.M
Is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.
As part of normal mammalian sexual reproduction, a diseased or absent uterus does not allow normal embryonic implantation, effectively rendering the female infertile.
This phenomenon is known as Absolute Uterine Factor Infertility (AUFI).
Uterine transplant is a potential treatment for this form of infertility.
Uterus is a dynamic, complex organ. It is hugely blood-flow dependent.
More than 116,000 Number of men, women and children on the national transplant waiting list as of August 2017.
33,611 transplants were performed in 2016.
20 people die each day waiting for a transplant.
every 10 minutes another person is added to the waiting list.
This document discusses the investigation and management of postmenopausal uterine bleeding. It describes the most common causes as atrophic vaginitis (60-80%), estrogen treatments (15-25%), and polyps (2-12%). Transvaginal ultrasound is recommended to measure endometrial thickness, with <3mm making cancer unlikely. Additional tests may include saline infusion sonography, hysteroscopy, and endometrial biopsy. Treatment depends on the cause but includes topical estrogen for atrophic vaginitis, polypectomy, and hysterectomy with bilateral oophorectomy for cancer. Recurrent bleeding warrants hysteroscopy and dilation and curettage.
This document outlines 10 secrets to success for intrauterine insemination (IUI). It discusses factors such as choosing the right patients based on their infertility diagnosis and prognosis, understanding the patient's ovarian and endometrial response based on age and biomarkers, using an individualized ovarian stimulation protocol, modifying treatment based on endometrial thickness, proper follicle monitoring and HCG trigger timing, optimizing IUI timing and semen preparation, ensuring proper IUI technique, providing luteal phase support with vaginal progesterone, knowing when to stop IUI treatment, and maintaining a cohesive team with thorough documentation and analysis of results. The overall message is that success in IUI lies in attention to many details of patient selection, treatment planning
This document discusses the importance of evidence-based fertility practice. It provides examples of how evidence-based medicine involves asking answerable clinical questions, acquiring the best evidence to answer those questions, and appraising the validity and applicability of the evidence. The document gives examples of evaluating studies on using metformin for PCOS and triggering ovulation with HCG. It emphasizes integrating the best available evidence with clinical expertise and patient values and preferences.
Uterine fibroids are common non-cancerous tumors that can affect fertility. Submucosal fibroids that distort the uterine cavity have been shown to decrease pregnancy rates, while evidence for intramural fibroids is less clear. Treatment options include medical therapy, uterine artery embolization, hysteroscopic or laparoscopic myomectomy. Myomectomy can improve fertility outcomes, especially for submucosal fibroids, but carries risks of adhesion formation and possible increased risk of uterine rupture in future pregnancies. More research is still needed to fully understand the relationship between fibroid location, size and infertility.
IUI remains an effective treatment option for certain fertility issues like unexplained infertility, mild male factor infertility, and infertility due to cervical factors. Stimulated IUI cycles have higher success rates than natural cycles. Optimal timing of IUI is 36-40 hours after hCG administration. IUI can be considered for poor responders to IVF as an alternative to cancellation. Success rates of IUI decline significantly after age 40. IUI may not be as effective as IVF for cases involving distal unilateral tubal blockage or hydrosalpinx. Strict protocols should be followed when performing IUI for HIV discordant couples.
The document provides guidelines for making IUI cost effective. It recommends proper patient selection, necessary investigations like checking tubal patency and ovulation, and optimum monitoring. It suggests using low doses of gonadotropins for stimulation and a single insemination per cycle. The number of IUI cycles should be decided based on factors like age, with a maximum of 6 cycles for patients under 35. Referral to IVF should be done at the appropriate time. Close monitoring involves tracking follicle growth and an hCG trigger when the follicle reaches 18mm. The guidelines aim to individualize treatment and keep the process as simple as possible to reduce costs.
Fertility preservation in Cancer patientsArunSharma10
The need for fertility preservation
Chemotherapeutic drugs according to gonadotoxicity level
Fertility preservation: subject of continuous review by experts
Non-oncological conditions requiring fertility preservation
Delayed childbearing
AVAILABLE PROCEDURES FOR FP
Embryo and oocyte cryopreservation
Luteal Phase - Clinical Point of View - By Dr Dhorepatil BharatiBharati Dhorepatil
Maintenance of pregnancy
Corpus luteum Progesterone
After ovulation ~ during the early first trimester ~ until placental function established
Removal of the corpus luteum spontaneous pregnancy loss
Ovarian progesterone production implantation & early pregnancy
This document discusses different methods for endometrial preparation in frozen embryo transfer cycles. It summarizes that:
1) Natural cycles can be used for younger patients but have limitations like irregular cycles and difficulty timing ovulation.
2) Hormonally controlled cycles using estrogen and progesterone with or without GnRH agonists are effective options. Exogenous hormone administration without GnRH agonists is now commonly used as it is simple and effective.
3) Factors like embryo quality and endometrial thickness predict success, but preparation method, hormone type/administration, and cryostorage length do not affect outcomes. The best predictors are good quality embryos and a tri-laminar endometrial pattern.
Robotic surgery has advantages over conventional and laparoscopic surgery for gynecological procedures. The da Vinci surgical system allows for precision in complex surgeries through its three-dimensional view and wristed instruments. Robotic surgery results in less blood loss, quicker recovery times, and fewer complications compared to open surgeries. While further research is still needed, robotic surgery has become a common method for hysterectomies and myomectomies to treat conditions like fibroids and cancer. The case study describes a large fibroid removed robotically with minimal blood loss and fast recovery for the patient.
Fertility preservation options are important for cancer patients of reproductive age undergoing treatment. For women, established options include embryo freezing for married patients and oocyte freezing for single patients, both of which require delaying cancer treatment. Ovarian tissue freezing can be done at any age or relationship status and does not delay treatment, but reimplantation success is currently low. For pre-pubertal patients, ovarian tissue or testicular tissue freezing are the only available options. Future methods may allow in vitro gamete maturation or stem cell derived gametes. Multidisciplinary care and individualized counseling are key to help patients preserve their fertility whenever possible before cancer treatment.
This document lists the professional qualifications and positions held by Dr. Laxmi Shrikhande, including Chairperson for various medical committees, publications, awards received, and presentations given. It then provides an overview of her upcoming presentation on Perimenopausal Bleeding, covering definitions, classifications, evaluation, treatment options for structural and non-structural causes, and specific treatment approaches like hormonal therapy, NSAIDs, and levonorgestrel intrauterine devices.
1. Thyroid disorders are common in pregnancy, affecting 1-2% of pregnant women. Optimal management is important for pregnancy outcomes.
2. Hypothyroidism and hyperthyroidism can cause complications for both mother and fetus if not treated properly. Levothyroxine is the treatment of choice for hypothyroidism. Antithyroid drugs are used to treat hyperthyroidism.
3. Factors like hCG and estrogen increase thyroid function in pregnancy, requiring adjustments to diagnosis and treatment of thyroid disorders compared to non-pregnant individuals. Monitoring of thyroid levels is important during and after pregnancy.
This document discusses ovarian cortical strips transplantation as a method for fertility preservation. It describes how ovarian cortical tissue can be removed, prepared into thin strips, and transplanted to various locations in the body. Locations mentioned include remaining ovaries, pelvic walls, abdominal muscles, and under the skin of the forearm or abdomen. The goals are to maintain hormone levels and potentially allow for future natural conception. Success is determined by restoration of hormone levels and follicular development visible on ultrasound over subsequent months.
Antenatal care involves regular checkups during pregnancy to monitor the health of the expectant mother and baby. The goals are to reduce mortality and morbidity, identify issues, and educate mothers. Checkups are usually every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and weekly until delivery. Appointments include health history, physical exam, lab tests, ultrasound, and health advice covering hygiene, nutrition, exercise, sleep, and danger signs. The overall aim is a healthy pregnancy and delivery.
The document discusses postpartum care and assessment. It describes how the body reverts to its pre-pregnancy state after childbirth and defines the postpartum period. It outlines components of a postpartum exam including assessing the breasts, uterus, bladder, bowels, lochia, episiotomy, Homan's sign, and emotional status. It provides guidance on common concerns like breastfeeding, bleeding, bowel movements, and perineal care. The document aims to inform nurses on properly examining and caring for postpartum patients.
Postnatal care (PNC) for the mother should respond to her special needs, starting within an hour after the delivery of the placenta and extending through the following six weeks. The care includes the prevention, early detection and treatment of complications, and the provision of counselling on breastfeeding, birth spacing, immunization and maternal nutrition. To standardise the PNC service, you are advised to use the screening, counselling and postnatal care cards. These cards ensure that you have covered all the essential steps in every home visit.
this ppt is beneficial for nursing and obstetric and gynaecology students.
Information For You After a Pelvic Floor Repair OperationMichelle Fynes
This document provides information for women recovering after a pelvic floor repair operation. It details what patients can expect in terms of usual hospital stay length, common after-effects like pain and bleeding, and advice on activities like exercise, diet, and returning to normal activities. The document emphasizes the importance of rest, pelvic floor exercises, mobility, and following an enhanced recovery program to aid in healing and returning to full health as quickly as possible after surgery.
This document provides an outline for a presentation on minor discomforts during pregnancy. It is divided into three sections focusing on the first, second, and third trimesters. For each trimester, the most common minor discomforts are listed along with their causes and nursing care recommendations. The objectives of the presentation are also stated. Some of the minor discomforts discussed include nausea and vomiting, urinary frequency, breast tenderness, constipation, heartburn, and shortness of breath. For each issue, specific causes related to hormonal and physical changes in pregnancy are described, as well as non-pharmacological nursing interventions.
Pregnancy involves many physical and lifestyle changes for the mother. The document provides information on common symptoms during pregnancy like nausea and backaches. It discusses the importance of a healthy, balanced diet with sufficient calcium, iron and proteins. Self-care recommendations include proper hygiene, exercise and getting sufficient medical care and checkups. The post-pregnancy section covers breastfeeding, post-delivery recovery, family planning and contraceptive options.
This document provides information about antenatal physiotherapy including its aims, guidelines, exercises and common discomforts during pregnancy. The aims are to improve mother and baby's health and ensure they are prepared for labor, lactation and infant care. Guidelines include warming up, avoiding jerky movements, and stopping exercises if pain occurs. The exercise plan progresses from warm up to aerobic to strengthening and relaxation. Common discomforts like nausea, heartburn and backache are discussed with tips for management.
NURSING MANAGEMENT DURINGTHE POSTPARTUM PERIOD 2021.pdfssuser873e5a1
The document discusses nursing management of the postpartum period, including assessing the physical and emotional changes a woman experiences, monitoring for complications, and providing education on self-care and infant care. It outlines the assessments nurses should perform, including vital signs, a head-to-toe examination checking systems like breasts, uterus, bladder, and lochia, and ensuring the woman's needs are addressed during recovery. The goal of postpartum care is to help the woman and family adapt to the newborn while assisting recovery and identifying any deviations from normal postpartum progression.
The female reproductive system is a very complex system. And as with any system, occasionally, things go wrong. When treatments and therapies can't fix an issue, sometimes surgery is required. Surgery to remove a woman's uterus or womb, a major component of this system, is called hysterectomy
Regular exercise during pregnancy provides several health benefits such as reducing backaches, preventing gestational diabetes, and improving mood and energy levels. While pregnant, it is safest to avoid high-impact activities like downhill skiing, contact sports, and scuba diving due to risks of falling or lack of oxygen. Low-impact exercises like walking, swimming, cycling, and modified running are generally safe. It is important to listen to your body and stop exercising if you experience symptoms like dizziness, bleeding, or decreased fetal movement.
This document outlines the common health issues that can occur in the postpartum period and provides guidance on physiotherapy exercises and practices to aid recovery. It discusses common problems like cramps, incontinence, back pain and more. It then describes the RICE method for recovery from stitches or swelling and provides tips for mobility, bladder/bowel health, pelvic floor exercises, abdominal exercises, back care and more. The overall document serves as a guide for physiotherapy practices to support postpartum recovery.
When it comes to good positions to use while breastfeeding, your comfort as well as the ease with which your baby will be able to feed is the first and foremost concern. Finding a position that you are most comfortable and happy with will make it easier for your baby to latch on to your breasts and feed with ease. Here are some of the best breast-feeding positions that you might use when you are breastfeeding.
This document provides guidelines for exercise during pregnancy. It recommends that pregnant women maintain regular moderate exercise for at least 30 minutes per day to help with health, comfort, and labor preparation. Walking and swimming are considered safe activities. High-impact exercise and activities with risk of falling or injury should be avoided. The document also provides specific exercise guidelines and recommendations, including tailoring exercises and Kegel exercises to strengthen pelvic floor muscles. Women are advised to listen to their body and consult their doctor regarding an exercise routine during and after pregnancy.
Over 536,000 women die annually from complications during pregnancy, childbirth, or the postpartum period, nearly all occurring in developing countries with higher fertility rates. Postnatal care involves examining both the mother and baby after birth and providing advice on health, breastfeeding, immunizations, family planning, and signs of complications. The mother is assessed for issues like bleeding, breast health, bladder function, bowel movements, and emotional state while the baby is examined and the mother educated on newborn care.
Basic concept about breastfeeding, why it is important, how it should be successful, benefits over bottle feed or commercial formula, types of breast milk, nutrition composition
The document discusses the needs and care of mothers during the postpartum period. Some key points:
- The postpartum period lasts 6 weeks as the body returns to its pre-pregnancy state. This time brings physiological, emotional, and social transitions.
- Major health challenges include postpartum hemorrhage, preeclampsia/eclampsia, puerperal infections, thromboembolic diseases, and psychological issues.
- Postnatal care aims to detect and treat complications, provide information for healthy outcomes, and restore the mother's health. It includes examinations, counseling, education, supplementation, and referrals for emergencies.
- Mothers' needs include rest
Cse lecture presentations 1st years full time 2016johnchaumba1
This document discusses various methods of contraception to prevent unintended pregnancy. It begins by defining unintended pregnancy and explaining that the best way to prevent it is abstinence. It then covers multiple female contraceptives like birth control pills, implants, IUDs, and female sterilization. Male contraceptives like condoms and male sterilization are also discussed. Natural family planning methods and their estimated effectiveness are described. The document provides details on how to properly use various contraceptives and emphasizes that dual protection from pregnancy and STIs requires consistent and correct use.
This document discusses various danger signs of pregnancy including vaginal bleeding, seizures, headaches, severe abdominal pain, fever, edema, and low fetal movement. It provides information on the causes, symptoms, and treatment for each of these issues. Vaginal bleeding could indicate ectopic pregnancy, miscarriage, or other complications. Seizures and headaches during pregnancy can affect the fetus and require careful management. Abdominal pain may be caused by gas, ligament pain, or constipation. Fever should be treated based on its underlying cause. Edema and swelling are common but can become problematic. Low fetal movement warrants monitoring to check on the baby's wellbeing.
A complete question and answer ppt on Menstruation and related queries, questions. Find information about Period pain, excess bleeding,PCOD/PCOS, menopause and much more...
Types of delivery And Physiotherapy management after c-section.pptxRajveer71
This document provides information on different types of childbirth, including:
1. Vaginal delivery - the natural birth process where the baby passes through the birth canal. It has benefits like shorter recovery but risks like respiratory issues for babies.
2. C-section - a surgical procedure where the baby is delivered through incisions in the abdomen and uterus. It may be scheduled or due to complications. Transverse or vertical incisions can be used.
3. Post c-section exercises include belly breathing, pelvic floor exercises, low-impact exercises like wall sits and leg slides, and scar massage to improve range of motion. Always consult a doctor before beginning an exercise routine after c-section.
This document provides guidelines for evaluating and treating male infertility. It discusses when to evaluate couples for infertility, how to perform semen analysis according to WHO guidelines, and how to differentiate between obstructive and non-obstructive azoospermia. It provides recommendations on treating varicoceles, lifestyle factors, oxidative stress, and infections. For non-obstructive azoospermia, it discusses evaluating genetic causes and techniques for sperm retrieval like microdissection testicular sperm extraction. Medical therapies for infertility including hormones, antioxidants, and supplements are discussed along with their effectiveness. The document concludes by discussing fertility preservation and future areas of research like gene therapy.
Dear Doctors, this 6-minute video contains the Abdominal Cerclage and Isthmocoele Repair procedure performed on a patient, also the history and post-procedure advice. Do watch and add to your expertise. Thank you.
Visit: a4hospital.com
#adbomicalcerclage #patientvideo #procedure #surgeryday #Cervicalcerclage #newsletter #treatment #doctor #pregnancy #a4hospital #a4fertilitycentre #chennai #ivfcentreinchennai #chennaigynecologist #fertilitycentrechennai
Cervical cerclage is a surgical procedure where stitches are placed around the cervix to help prevent preterm birth. There are different types of cerclage indicated for various high-risk situations like previous preterm births, cervical insufficiency, or short cervix found on ultrasound. Cerclage can be placed transvaginally or transabdominally depending on the situation. Risks include infection or early rupture of membranes, but cerclage has been shown to delay delivery by 5 weeks on average in rescue situations. The cerclage is usually removed between 36-37 weeks to allow for normal vaginal delivery. Cervical pessaries are a non-surgical alternative that can also help support the
Breastfeeding tips for new moms by Dr Lavanya, Pediatrician, A4 hospital and Fertility Centre, Chennai.
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Danger signs in the newborn by Dr. Lavanya, Pediatrician, A4 Hospital and Fertility Centre, Chennai.
#newborn #dangersigns #pregnancytips #pregnancycare #childcare #childtips #babycare #a4hospital #a4fertility #fertilitycentre #chennai
Postnatal - Newborn care by Dr Lavanya, A4 Fertility Centre, Chennai
**Content**
-Postnatal environment
-Everyday care
-Breastfeeding - Cradle hold
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-Eye care
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-Stools in baby
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Ovulation induction - not all fertility treatment is IVF by Dr Aishwarya Parthasarathy, Fertility specialist, A4 Fertility Centre, chennai
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Ectopic pregnancy by dr aishwarya, a4 fertility centre, chennai
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TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kol...rightmanforbloodline
TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Versio
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TEST BANK For An Introduction to Brain and Behavior, 7th Edition by Bryan Kolb, Ian Q. Whishaw, Verified Chapters 1 - 16, Complete Newest Version
Muktapishti is a traditional Ayurvedic preparation made from Shoditha Mukta (Purified Pearl), is believed to help regulate thyroid function and reduce symptoms of hyperthyroidism due to its cooling and balancing properties. Clinical evidence on its efficacy remains limited, necessitating further research to validate its therapeutic benefits.
Promoting Wellbeing - Applied Social Psychology - Psychology SuperNotesPsychoTech Services
A proprietary approach developed by bringing together the best of learning theories from Psychology, design principles from the world of visualization, and pedagogical methods from over a decade of training experience, that enables you to: Learn better, faster!
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
Histololgy of Female Reproductive System.pptxAyeshaZaid1
Dive into an in-depth exploration of the histological structure of female reproductive system with this comprehensive lecture. Presented by Dr. Ayesha Irfan, Assistant Professor of Anatomy, this presentation covers the Gross anatomy and functional histology of the female reproductive organs. Ideal for students, educators, and anyone interested in medical science, this lecture provides clear explanations, detailed diagrams, and valuable insights into female reproductive system. Enhance your knowledge and understanding of this essential aspect of human biology.
Integrating Ayurveda into Parkinson’s Management: A Holistic ApproachAyurveda ForAll
Explore the benefits of combining Ayurveda with conventional Parkinson's treatments. Learn how a holistic approach can manage symptoms, enhance well-being, and balance body energies. Discover the steps to safely integrate Ayurvedic practices into your Parkinson’s care plan, including expert guidance on diet, herbal remedies, and lifestyle modifications.
2. PROCEDURE
OF
EMBRYO
TRANSFER
• After Embryo transfer , you will
resting in couch for 10-15 minutes.
• You can pass urine and rest in your bed
for 3 hours
• If done under Anesthesia, diet can be
taken only after 3 to 4hours
• Otherwise, normal diet
• Will get a shot of Injection Progesterone
and or Hcg
3. Tony Wilson
Programmer
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UTERUS
AND
ENDOMETRIUM
6. Rest After
Embryo
Transfer
• For 3 to 4 hours in Hospital
If needed, can stay in Hospital for a
day.
• Mostly can get back home in Car
• Rest for a day or two
• After that can go ahead with
Modified Physical rest
7. MODIFIED PHYSICAL REST
•No Strenuous activity, lifting heavy
weight
•Avoid Twisting, Jerky movements
•Can be active in home or work
•Plan to be stress free
•Can do cooking , except using
Grinder / Mixer
8. EXERCISE AND YOGA AFTER ET
•Can continue exercises that are
safe during pregnancy like Walking
•Can do arm, leg and Back
strengthening exercises with
Proper warmup and Stretching
•Can do Yoga that are safe during
pregnancy
10. TRAVEL AFTER EMBRYO TRANSFER
• Can go in car for short shopping, Movie
• But be careful on road bumps.
• Relax and enjoy safely
• Not Happy with bike or auto travel
11. Can I climb stairs - Yes
Can I use Indian Toilet - Yes
Can I drink Hot Water - Yes
Can I bath daily - Yes
Can I bath in Hot Water - No
Can I take Head Bath - Yes
Can I have sex after ET - No
12. EFFECTS OF STRESS/ POSITIVE ATTITUDE!
• Stress hormones can lower your
Reproductive hormones like Progesterone
and estrogen , having negative effect
• Toxins accumulate in body with stress
• Don’t be bedridden and get stressed
Both in general and infertile population, distress was
respectively associated with decreased conception
rates and long menstrual cycles (≥35 days) and lower
outcomes of reproductive medicine, including oocytes
retrieved, fertilization, pregnancy and live birth rates
13. • Infographic Style
WATER INTAKE AFTER EMBRYO TRANSFER
•Can continue exercises that are safe
during pregnancy like Walking
•Can do arm , leg and Back
strengthening exercises with Proper
warmup and Stretching
•Can do Yoga that are safe during
pregnancy
14. Add Text Here
DIET AFTER EMBRYO TRANFSER
High Calorie Fruits to avoid VegetablesFruits
• Pomegranate
• Orange
• Sweet lime
• Berries
• Apple
• Kiwi
• Melons
• Pear
•Banana
•Chikoo
•Mango
•Grapes
•Jack Fruit
• Raw papaya
• Pineapple
•Potato with skin
•Spinach soup
•Tomatoes
•carrot
•Beetroot
•Almost all
vegetables are
good to have
15. FOODS TO EAT
• Better to take foods Containing
Vitamin B6, B12
• Calcium rich foods
16. LINK TO SEARCH AND
UPDATE
https://americanpregnancy.org/pregnancy-
health/diet-during-pregnancy/
https://www.nhs.uk/conditions/pregnancy-and-
baby/healthy-pregnancy-diet/
https://www.choosemyplate.gov/myplatekitchen
17. FOODS TO AVOID DURING PREGNANCY
• Caffeine ( Coffee, Tea, Chocolate) , not more than 200
milligrams per day
• Papaya, Pineapple, lots of grapes
• Mercury in some types of fish – shark, swordfish, king
mackerel
• Liver of Meat /chicken should not be taken often, as it
contains more Vitamin A
• Cakes, biscuits, cookies, chips and candy
• Raw / under cooked – veggies, egg, meat
• Alcohol and smoking
18. 1
2019-2020
COVID-19
Virus Source Cases
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19. SUPPLEMENTS AFTER EMBRYO TRANSFER
* Vitamin C - 500mg per day
* Vitamin E – vegetable oil, nuts,
spinach
* Vitamin D 60,000k weekly once for
8 weeks with milk and then monthly
once during pregnancy
20. You can Resize without
losing quality
You can Change Fill
Color &
Line Color
FREE
PPT
TEMPLATES
MEDICATIONS AFTER EMBRYO TRANSFER
Estrogen – Progynova / Evatone
Ecospirin – 75mg
Progesterone – Oral – Duphaston
_ Per vaginal- 400mg twice daily
Injections HCG - 5 days once
Injections Heparin - Daily if need
21. Per Vaginal
Inserion
After
Embryo
Transfer
• Wash the private area with vaginal wash
• Insert capsule with one finger atleast ¾ th
finger should be inserted
• Can lie down for 30min
• Need not lie down , if situation doesn't permit
22. WHAT ARE THE SYMPTOMS AFTER ET
•Some might have – Mild cramps,
spotting, breast tenderness, nausea,
vomiting, bloatedness
•Some may not have any of these.
•No need to worry, stay positive and
do the test at the prescribed time
23. How to Confirm Pregnancy?
After ET,
15 days later can do serum beta Hcg
Value more than 50 mIU/ml - +ve
+ve - Congrats on the result but stay relaxed
during pregnancy
-ve – Donot worry, we have done the best , so
we will be together and fight infertility